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      Patient Preference and Adherence (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on the growing importance of patient preference and adherence throughout the therapeutic process. Sign up for email alerts here.

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      Adherence to Self-Care Practices and Associated Factors Among Outpatient Adult Heart Failure Patients Attending a Cardiac Center in Addis Ababa, Ethiopia in 2020

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          Abstract

          Introduction

          Proper self-care in patients with chronic illnesses, such as heart failure is allied with the prevention or early detection of health problems and improved clinical outcomes. Even though self-care among patients with heart failure is commonly poor, a low-sodium diet, regular exercise, and weight monitoring are essential to control heart failure symptoms and exacerbation. Poor adherence to these self-care practices contributes to an increase in hospitalization, morbidity, and mortality.

          Objective

          To assess adherence to self-care practices and associated factors among outpatient adult heart failure patients attending cardiac center in Ethiopia, Addis Ababa, 2020.

          Methods

          Institution-based cross-sectional study design was used to incorporate 396 heart failure patients who attended the cardiac center in Ethiopia, Addis Ababa. The study was conducted from March to April 2020. Study participants were selected by using a systematic sampling technique. Data were collected through face-to-face interviews and from the patients’ medical records. Epi-data version 3.1 and SPSS version 26 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed to identify predictors of self-care practice. Those variables with p-value <0.25 in the bivariable regression analysis were entered into the multivariable regression analysis and the result were presented using tables, chart, and mean.

          Results

          Of 396 respondents, 111 (28%) of patients with heart failure had overall good self-care adherence. Comorbidity (AOR: 1.62; 95% CI: 1.07–2.624), level of knowledge (AOR: 3.58; 95% CI: 2.23–5.79) and depression (AOR: 2.45; 95% CI: 1.048–5.726) were factors significantly associated with adherence to self-care practice.

          Conclusion

          Comorbidity, inadequate knowledge, and depression were predictors of self-care practice. As a result, nursing intervention programs regarding knowledge on heart failure are recommended for enhancing self-care practices. Self-care strategies shall target patients with depression and comorbidity.

          Most cited references19

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            2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

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              Cardiovascular risk and events in 17 low-, middle-, and high-income countries.

              More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater risk-factor burden). Participants were followed for incident cardiovascular disease and death for a mean of 4.1 years. The mean INTERHEART Risk Score was highest in high-income countries, intermediate in middle-income countries, and lowest in low-income countries (P<0.001). However, the rates of major cardiovascular events (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) were lower in high-income countries than in middle- and low-income countries (3.99 events per 1000 person-years vs. 5.38 and 6.43 events per 1000 person-years, respectively; P<0.001). Case fatality rates were also lowest in high-income countries (6.5%, 15.9%, and 17.3% in high-, middle-, and low-income countries, respectively; P=0.01). Urban communities had a higher risk-factor burden than rural communities but lower rates of cardiovascular events (4.83 vs. 6.25 events per 1000 person-years, P<0.001) and case fatality rates (13.52% vs. 17.25%, P<0.001). The use of preventive medications and revascularization procedures was significantly more common in high-income countries than in middle- or low-income countries (P<0.001). Although the risk-factor burden was lowest in low-income countries, the rates of major cardiovascular disease and death were substantially higher in low-income countries than in high-income countries. The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization. (Funded by the Population Health Research Institute and others.).
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                ppa
                ppa
                Patient preference and adherence
                Dove
                1177-889X
                15 February 2021
                2021
                : 15
                : 317-327
                Affiliations
                [1 ]Department of Adult Health Nursing, College of Medicine and Health Sciences, Woldia University , Woldia, Ethiopia
                [2 ]Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wollo University , Dessie, Ethiopia
                [3 ]Department of Pediatrics and Child Health Nursing, Wollo University, College of Medicine and Health Sciences , Dessie, Ethiopia
                Author notes
                Correspondence: Mulugeta W/Selassie Gebre Department of Pediatrics and Child Health Nursing, Wollo University, College of Medicine and Health Sciences , P.O. Box 1145, Dessie, EthiopiaTel +251 911954032Fax +251 333115277 Email alzunfa@yahoo.com
                Author information
                http://orcid.org/0000-0002-8143-987X
                http://orcid.org/0000-0003-1001-7466
                http://orcid.org/0000-0002-3027-0162
                Article
                293121
                10.2147/PPA.S293121
                7894823
                33623373
                d3012a51-9d5f-4a26-bc53-6a4f757786fc
                © 2021 Tegegn et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 02 December 2020
                : 30 January 2021
                Page count
                Figures: 2, Tables: 6, References: 19, Pages: 11
                Funding
                Funded by: Wollo University;
                The funding process was financially supported by Wollo University.
                Categories
                Original Research

                Medicine
                self-care,adherence,heart failure
                Medicine
                self-care, adherence, heart failure

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